Were there such a thing as a website with a bedside manner, it would surely be www.ukonlinepharmacy.com.

With its crisp design and the photograph of six white-coated pharmacists smiling out at you, there seems little doubt that this is the real thing. Respectable. Dependable. Solid. And it seems so much more efficient than your regular pharmacist.

Here, you can get whatever you want without the hassle of going to your doctor for a prescription. Need pills for diabetes, cancer or high blood pressure? No problem. Want medication for those embarrassing ailments - impotence, hair loss, obesity? Just punch in your credit card details.Amy Pain

Amy Pain, 22, was found dead in bed by her father, the Archdeacon of Monmouth, the Ven Richard Pain, at their vicarage home in October

The site can even help if your tranquilliser of choice, say diazepam, is no longer prescribed by your doctor.

You can have 60 pills for $259 (£176). That's just $4.32 (£2.94) per tablet! But hang on a minute.

Why is a site called uk-online-pharmacy charging in dollars, and why is there no address or phone number listed? If you have the common sense to ask yourself these questions before you use drugs from sites such as these, you might just be saving your life.

For this is a world of self-medication and fake drugs, a world where at best you may be conned, and at worst you could end up dead.

More...

* The runaway epidemic that blights the lives of 2.5m Britons - and could soon hit 1.5m more * Five of the best heart monitors * Why soya may not be such a super food after all

According to the World Health Organisation, the trade in illegal and counterfeit drugs is worth £18billion a year - though some investigators believe the figure is much higher - and it may be responsible for as many as half a million deaths worldwide.

And if you are foolish enough to buy online, the same organisation estimates your chances of being sold fake medication at higher than 50-50.

Last year, enforcement authorities from 42 countries seized more than 11.1million counterfeit tablets, capsules and vials - a 28.9 per cent increase over 2007.

In 2005, there were just 500,000 seizures for the whole of Europe.

The dangers of buying drugs online were highlighted last week during an inquest into the death of 22-year-old Amy Pain, daughter of the Venerable Richard Pain, Archdeacon of Monmouth. Amy Pain

Amy died following an apparent accidental overdose of online pharmaceuticals she had been buying for insomnia, anxiety and stomach aches

The Archdeacon found Amy dead in bed last October following an apparent accidental overdose of online pharmaceuticals she had been buying for anxiety, stomach ache and insomnia.

During the inquest, the Gwent coroner David Bowen expressed concern over the ease with which prescription-only drugs could be bought over the internet without a prescription and said he would be contacting the relevant authorities to highlight the dangers.

In fact, the relevant authority in the UK, the Medicines And Healthcare Products Regulatory Agency (MHRA), already knows about the dangers, but is drowning in a sea of internet pharmaceutical fakery which it's almost powerless to stop, an organised crime wave that carries lower prison sentences than narcotics trafficking but which is many times more lucrative.

'If you go to South America to buy a kilo of cocaine, it is likely to cost you thousands of pounds even if you aren't killed before you manage to buy it,' said Jim Thompson, director of the UKbased campaign group European Alliance For Access To Safe Medicines (EAASM).

'But you can buy a kilo of sildenafil, the active ingredient in Viagra, for £35 and make 10,000 10mg tablets that sell illegally for around £10 each over the internet. That's a profit of almost £100,000. It's much more lucrative than class A drugs and the penalties for getting caught are much lower.'

(All of which helps explain the spam email advertisements for 'Viagra' with which most computers are bombarded every day.)

In the UK, unlicensed individuals who trade in prescription medicines may be charged with offences under the Medicines Act which carry a maximum of just two years in prison and/or an unlimited fine. Viagra

The financial rewards for making a fake version of Pfizer's Viagra, above, are much higher than making class A drugs

If, in turn, they are counterfeiting patented drugs, they face a maximum of ten years in prison and an unlimited fine under the Trade Marks Act.

These penalties are much lower than for class A drug-trafficking. Last August, for example, two men were sentenced to a total of 27 years at Nottingham Crown Court for money-laundering and trafficking in heroin, ecstasy and amphetamines.

The threat posed by fake drugs is serious.

Last year, a team led by Mr Thompson bought 36 batches of drugs online and found that almost two-thirds were counterfeit or of dangerously poor quality. They included the asthma drug Seretide, the high blood pressure pills Micardis and Coversyl, the schizophrenia medication Zyprexa, and the Alzheimer's treatment Aricept.

There were also Viagra pills for erectile dysfunction, the anti-obesity drug Reductil, the anti-ulcer medication Zoton and many others.

One delivery, for 16 Plavix heart pills (which were real), came wrapped in a copy of the Mumbai Daily News. There were no patient instructions, but there were two free Viagra pills (which turned out to be fake) and a letter thanking the buyer for their custom.

'If it wasn't so terrifying, it would be almost funny,' said Mr Thompson. 'Plavix is for people who have recently had heart attacks, strokes or heart surgery. To take a Viagra pill would probably kill them.'

The team also checked out 116 websites purporting to sell prescription drugs. Of those, 102 were prepared to sell without sight of a prescription.

This is illegal in the UK. There are genuine pharmaceutical websites such as Boots and Lloyds, but you must mail them a prescription before they will send you your medication.

'Any site that offers prescription drugs without a prescription is dangerous,' said Mr Thompson.

'And so are the drugs that they sell. If you buy them, you're playing Russian roulette. The last pill may not have killed you, but maybe the next one will.'

So, what are the consequences? First of all, fake drugs - obviously not all bought online - cause huge numbers of deaths. Investigators report finding pills made from rat poison, cement, floor polish, chalk, rice flour, lead paint and concentrations of real active ingredients that are so low or so high as to be dangerous.

The World Health Organisation estimates that as many as one-third of all drugs in developing countries may be fake.

In China alone, up to 300,000 people a year are thought to die because of substandard and fake medication. It is also believed that a fifth of the one million malaria deaths every year could be avoided if patients had access to genuine pharmaceuticals - rather than fakes.

In the West, deaths caused by internet fakes tend to come in ones and twos, not in the thousands.

Among those reported recently are a 58-year-old Canadian who died after taking fake sleeping pills laced with strontium, arsenic, aluminium and uranium; a man from Chicago who almost died after taking a fake Xanax tablet for anxiety which contained four times the normal amount of active ingredients; and an American woman who died after taking counterfeit medication laced with aluminium.

According to Archdeacon Pain, it is not thought any of his daughter Amy's medication contained anything that it shouldn't have. He will not say exactly what pills she was taking, but he will say what type; for anxiety and problems sleeping. She had suffered from anxiety for many years.

'Amy had had problems over a long period of time, but at the time of her death she was happy and content,' he told me.

'In common with a lot of people who self-medicate, she was wise and intelligent and had done a lot of research into her problems and the medication available, and I know she was buying medicines that had been prescribed for her in the past.

'My wife, Julie, and I have reflected on this and our concern is that it is young and vulnerable people who are likely to be attracted to buying medicine on the internet. And perhaps those with mental health issues who feel the need to take control of their lives find that this is one such way of taking control.'

Amy might have been one of the lucky ones to receive genuine medication, but Archdeacon Pain says she was not getting prescriptions from a doctor and, therefore, her intake was not being monitored.

He believed she was going to reputable websites - but if they were dispatching drugs to the UK without prescriptions then, by definition, they were not operating legally.

'I would advise anyone against using websites that offer prescription medicines without a prescription,' said Archdeacon Pain.

'We believe Amy's medication was genuine, but it would appear that many of them aren't. Not only is that a cause for concern, but without seeing a GP you might be taking certain combinations of medicines that could be dangerous.'

So, what can be done about illegal online pharmacies?

Well, not much. It is not uncommon for the crooks who set them up to be based in, say, Russia, to have their pills made in India and packaged on the South Pacific island of Vanuatu. The computer server that processes their business could be in the U.S. and their bank in Panama.

Since 1994, the Medicines And Healthcare Products Regulatory Agency has brought 11 successful prosecutions in the UK against 18 individuals for involvement in the supply of counterfeit medicines.

A further three prosecutions involving six people have been brought by the Crown Prosecution Service and there are six more prosecutions pending involving nine defendants.

But, in reality, most offenders are based overseas, so there is little the authorities here can do.

Steve Allen, a former detective sergeant with the National Crime Squad, is senior director of global security at Pfizer, the world's biggest pharmaceuticals company and the manufacturer of Viagra and the anti-cholesterol drug Lipitor, the two drugs most copied by criminals.

He said: 'We might find a website selling pharmaceuticals illegally and have it closed down one day, but then it will just pop up with another name the day after.

'It is such a lucrative business that very organised criminals are involved whose activities go largely unchecked. We advise customs authorities around the world on what to look for but, in fairness, they spend most of their time looking for cocaine, heroin and ecstasy, or for signs of people-smuggling or arms-dealing. They're not really on the lookout for people carrying cases of fake medicines.'

All those I spoke to felt UK legislation was sufficient to deal with bogus drugs being sold here, but British law does not extend to websites being run in Third World countries where there is little or no regulation.

Instead, they believe the answer is to warn people to go nowhere near such sites, to have regard for their money and their health.

'Many of these pills are made in dirty backstreet laboratories in places like China or Afghanistan,' said David Pruce, director of policy at the Royal Pharmaceutical Society of Great Britain. '

And some of the operations have been linked to organised crime and even terrorism. Some of the websites might appear to be respectable, but if they are prepared to supply you with prescription medicines without a consultation or a prescription, then they are operating illegally.

'If they were operating legally then they would have a bricks-and-mortar address, a telephone and the name of at least one pharmacist whom you can call. If they don't - and they rarely do - then you would be advised to have nothing to do with them.'

So, what of www.ukonlinepharmacy.com? In fact, it is not based in the UK at all, but was registered on September 22, 2006, by an organisation called DomainsByProxy.com based in Scottsdale, Arizona.

When I called to ask who was behind the online pharmacy and where they were based, one of its sales and support staff, Randi Caywood, said: 'DomainsByProxy is a means by which people can withhold their information and it would be against the law for me to give you any details about that account.'

Randi suggested I make a complaint on her company's website, which I tried to do, explaining that it was illegal to provide prescription drugs in the UK without a prescription.

But the site told me that all the details I had entered, from my email address to my phone number, were invalid, and refused to process my complaint.

I shouldn't really be surprised.

From start to finish, this is a pretty sick business - preying on people willing to risk their health in the hope of making themselves feel better, however illegal the methods.

In reply to Re: UK paper warning on buying drugs online, posted by desolationrower on April 27, 2009, at 11:53:17

> i laughed a bit, but i think i prefer the comic stylings of david brent.> > -d/r

Lol! While I don't doubt there is some truth in their claims, the Daily Mail is a right-wing scandal sheet that manipulates readers through fear.

If you read it on a daily basis you'd conclude that British society was breaking down and the entire world was going to hell in a handcart.

It's known for poorly-researched health stories with little grounding in fact or science. On bad-science.net it has by far the most entries of any media organisation for sketchy science, including the recent howler that "facebook gives you cancer":